During conventional or endoscopic surgical procedures, such as open cholecystectomy or laparoscopic oophorectomy, introduction of medical devices, such as a cannula, stent, endoscope, aspirator, or pressure monitor, into a patient's body tissue often requires an incision on the body tissue. Sutures are generally required to establish hemostasis and secure the medical device onto the body tissue. Repositioning of the medical device requires loosening or removing the sutures and re-tightening or replacing the existing sutures with new ones.
During various cardiothoracic surgeries, such as coronary artery bypass graft, heart valve repair, septal defect repair, pulmonary thrombectomy, thoracic aortic aneurysm repair, atherectomy, and removal of atrial myxoma, cardiopulmonary bypass and cardiac arrest are often required. Cardiac arrest is generally achieved by infusing cardioplegic solution through an arterial catheter into the coronary ostia or through an atrial catheter into the coronary sinus. After the myocardium is paralyzed, cardiopulmonary bypass is required to support the peripheral circulation. Deoxygenated blood is usually drained through a venous cannula from the right atrium, superior vena cava, or inferior vena cava to a bypass-oxygenator, and oxygenated blood is returned from the bypass-oxygenator to the ascending aorta through an arterial cannula to perfuse peripheral organs.
The right atrial appendage is often incised to allow insertion of the venous return cannula or cardioplegic catheter during cardiothoracic surgeries. After the cannula is placed in the right atrium, a purse string suture is often placed on the atrial tissue around the incision site to achieve hemostasis, and the suture pulled tightly against the rigid cannula to secure the cannula. Disadvantages associated with the present technique are that (1) placing sutures on the atrium is time consuming, (2) repositioning of the cannula requires manipulating sutures on the atrial tissue, i.e. loosening and re-tightening sutures around the cannula, and (3) delicate atrial structures may be damaged due to suture placement and manipulation.
Methods and devices are therefore needed for sealing body tissues during introduction of other medical devices, that eliminate the need for sutures and reduce the risk of tissue injury during manipulation of other medical devices.